Provider Demographics
NPI:1326234089
Name:RAPID KNEE REHAB, LLC
Entity Type:Organization
Organization Name:RAPID KNEE REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-313-5633
Mailing Address - Street 1:PO BOX 1225
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-1225
Mailing Address - Country:US
Mailing Address - Phone:888-313-5633
Mailing Address - Fax:801-785-6599
Practice Address - Street 1:684 W 800 N
Practice Address - Street 2:SUITE 110
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3658
Practice Address - Country:US
Practice Address - Phone:888-313-5633
Practice Address - Fax:801-785-6599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6041570001Medicare NSC